A long-term care nurse about to give a daily dose of digoxin (Lanoxin) is told that a serum digoxin level drawn earlier in the day measured 2.7 ng/mL. The nurse should take which of the following actions first?
1. Administer the daily dose of the medication.
2. Report the finding to the health care provider.
3. Record the normal value on the intershift report sheet.
4. Gather data from the client related to signs of toxicity.
4
Rationale: The normal therapeutic range for digoxin is 0.5 to 2.0 ng/mL. A value of 2.7 ng/mL exceeds the therapeutic range and could be toxic to the client. The nurse should gather data about signs of digoxin toxicity and then notify the health care provider. "Record the normal value on the intershift report sheet" is incorrect because the value is high, not normal, and dismisses the subject at hand. "Administer the daily dose of the medication" is incorrect because the next dose should not be administered automatically.
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